What Does MACRA Mean for You?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) restructured several large aspects of Medicare, chiefly how physicians are paid for their services. While it was signed into law in April 2015 with widespread bipartisan support, MACRA’s changes that directly affect Medicare beneficiaries only began coming to fruition this year. What are these changes and what does MACRA mean for Medicare beneficiaries? When you see the different outcomes of this wide-reaching act, you’ll see how influential MACRA can be.

New Medicare Cards

One part of MACRA that many Medicare beneficiaries will be familiar with at this point is the new Medicare cards it called for. MACRA mandated the Centers for Medicare & Medicaid Services (CMS) update their card design to improve security. To abide by the law and help prevent fraud and protect against identity theft, CMS replaced Social Security numbers (SSNs) on Medicare cards with Medicare Beneficiary Identifiers (MBIs). The MBI is a randomly generated combination of letters and numbers used to quickly identify beneficiaries.

If you haven’t received your card yet, you have three simple options. The first thing you can do is call 1-800-MEDICARE and explain that you haven’t gotten your new card. The associate you’re speaking with should be able to verify your Medicare status and help you get a card. You can also log in to MyMedicare.gov to find your MBI and print out a Medicare card. Finally, you can ask your health care provider to find your MBI.

Updates for Medicare Supplement Plans

Another massive change that’s coming as a result of MACRA is in relation to Medicare Supplements. Specifically, two of the more comprehensive Medigap plans are being discontinued in 2020. These plans are Medigap Plans C and F, both of which are notable because they cover the Medicare Part B deductible. In fact, these are the only two Medicare Supplements that cover the Part B deductible, which is why they’re being discontinued. As part of MACRA, Congress voted to eliminate “first-dollar coverage,” which these two plans provide. Luckily, if you’re currently enrolled in either of these plans or enroll in one of them prior to 2020, you can keep your plan.

As part of MACRA, Congress voted to eliminate “first-dollar coverage,” which Medicare Supplement Plans C and F provide.

After 2020 starts, Medicare beneficiaries will also see changes relating to Medigap Plans D and G, which are similar to Plans C and F, respectively, minus coverage of the Part B deductible. Currently, Plans D and G aren’t guaranteed issue plans, but in 2020, they’ll become guaranteed issue plans for newly-eligible Medicare enrollees (people eligible for Medicare on or after January 1, 2020). Medicare-eligible individuals can enroll in guaranteed issue Medigap plans outside of their Medigap open enrollment period — even if they have past or present health conditions — as long as they have a guaranteed issue right. MACRA also creates a new, high-deductible Medigap Plan G plan.

Merit-Based Incentive Pay for Doctors

Perhaps the most significant change MACRA made — modifying the way physicians are paid — doesn’t directly affect beneficiaries, but it’s still worth being aware of. MACRA repealed the Sustainable Growth Rate Formula, which helped set the Medicare Part B reimbursement rate for doctors. In its place, the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (AMPS) were created under the Quality Payment Program. MIPS and AMPS measure performance under several categories, with the aim of rewarding excellent service from health care professionals.

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MACRA has made large changes to the way that Medicare works in the United States, some of which are behind the scenes. Whether you see them or not, though, they can and may actually affect you, especially if you’re in a Medicare Supplement plan or simply receive a new Medicare card. That’s why it helps to be aware of what these changes are and how they’ll influence your coverage.

If you have questions about your Medicare coverage or are looking for a change, it may be helpful to contact a licensed Medicare sales agent, who can answer your questions or help you find a plan that fits your needs.